[Disseminated tuberculosis with severe multi- organ failure in a patient with AIDS].
BACKGROUND
Tuberculosis is the most common infectious complication in HIV infected patients. The incidence of tuberculosis and the proportion of disseminated disease increase with more severe immuno-suppression. Septic shock and multiple organ failure are uncommon but are of markedly bad prognostic significance.


METHODS
A forty-four year old HIV seropositive man was admitted to the intensive care unit (ICU) with acute respiratory distress. The patient had been febrile for the previous two weeks. His thoracic radiograph showed a discrete interstitial infiltrate and at bronchoscopy small whitish granulations were observed in the main bronchi. All bacteriological investigations remained negative at the time of ICU admission. The patient died sixteen hours later due to multiple organ failure. Mycobacteria were identified after patient's death on the smear from BAL, from blood cultures, and in a postmortem liver biopsy.


CONCLUSIONS
Septic shock is an infrequent complication of disseminated tuberculosis. Mortality is very high. Treatment should be started early in cases with a high diagnostic suspicion.
Grigoriu
B-D
BD
Service de Réanimation médicale, Hôpital Antoine Béclère, Assistance Publique - Hôpitaux de Paris, Clamart, France. b_grigoriu@hotmail.com
Jacobs
F-M
FM
Mas
A-E
AE
Prat
D
D
Prévot
S
S
Brivet
F-G
FG
D017088:AIDS-Related Opportunistic Infections; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001999:Bronchoscopy; D006801:Humans; D007165:Immunosuppression Therapy; D007362:Intensive Care Units; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology* / Q000401:mortality; D013902:Radiography, Thoracic; D012131:Respiratory Insufficiency / Q000209:etiology; D012772:Shock, Septic / Q000209:etiology*; D014376:Tuberculosis / Q000150:complications* / Q000000981:diagnostic imaging
D019380:Anti-HIV Agents